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July 1, 1989Regional Anesthesia The Journal of Neural Blockade in Obstetrics Surgery & Pain Control

The Effect of Continuous Epidural Analgesia with Sufentanil and Bupivacaine During and After Thoracic Surgery on the Plasma Cortisol Concentration and Pain Relief

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Why the study?

Does continuous epidural analgesia with bupivacaine and sufentanil improve postoperative pain relief and reduce plasma cortisol concentration compared to systemic nicomorphine in patients undergoing thoracic surgery?

Population

20 patients undergoing thoracic surgery (two groups of ten)

Comparison

Continuous epidural analgesia with bupivacaine… vs Intermittent intravenous peroperative and…

Design

Cohort

Follow-up

3 consecutive days after surgery

Authors

SZSimon J. ZwartsRadboud University NijmegenHKH.G. KhoInstitute of Aging

Discussion

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Overview

Epidural analgesia may improve pain control after thoracic surgery; observational data leaves open effects on stress response and requires RCT confirmation.

Structured PICO

Does continuous epidural analgesia with bupivacaine and sufentanil improve postoperative pain relief and reduce plasma cortisol concentration compared to systemic nicomorphine in patients undergoing thoracic surgery?

P
Population
20 patients undergoing thoracic surgery (two groups of ten)
I
Intervention
Continuous epidural analgesia with bupivacaine 0.125% and sufentanil 0.83 micrograms.ml-1
C
Comparator
Intermittent intravenous peroperative and on-demand intramuscular postoperative analgesia with nicomorphine 0.2 mg.kg-1
O
Outcome
Plasma cortisol concentration and postoperative pain relief (measured with Inverse Linear Analgesia Scale, ILAS)patient reported

Continuous epidural analgesia with bupivacaine and sufentanil provides superior pain relief compared to systemic nicomorphine after thoracic surgery, without significant differences in plasma cortisol levels.

Cite This Study

Zwarts et al. (1989) studied this question.

synapsesocial.com/papers/6a9268a13eb7c78f2e41ec41https://doi.org/10.1136/rapm-00115550-198914040-00004
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Controlled Comparison of the Effects of Extradural Diamorphine and Bupivacaine on Plasma Glucose and Plasma Cortisol in Postoperative Patients1982 · 37 citations
  2. 2Epidural analgesia improves postoperative nitrogen balance.1978 · 167 citations
  3. 3Morphine Anesthesia Blocks Cortisol and Growth Hormone Response to Surgical Stress in Humans1974 · 150 citations
  4. 4Sex and surgical stress1981 · 14 citations